Without legislative action, taxes that fund Medicaid will sunset in the next two years, leaving a hole in the state’s budget.

At the end of a dramatic night on the House floor, Republicans on Tuesday narrowly passed a framework for massive cuts to taxes and spending that would likely reduce funding to Medicaid, raising loud objections from Democrats who universally opposed the measure.

Pennsylvania faces billions in Medicaid and other health funding cuts, which could force tens of thousands out of programs, under a budget resolution approved by Congressional Republicans, according to opposition groups.